This provider's $7.1M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 5.64x is significantly above the specialty median of 4.7x.
AI-generated analysis based on Medicare payment data.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $763.19 | $112.99 | 6.75x | $650.20 | $536.1K | 8.4K | 5.6K |
| 2015 | $843.05 | $122.05 | 6.91x | $721.00 | $583.2K | 8.7K | 6.1K |
| 2016 | $897.56 | $132.47 | 6.78x | $765.09 | $637.0K | 8.3K | 5.6K |
| 2017 | $850.93 | $121.38 | 7.01x | $729.55 | $709.9K | 9.9K | 6.6K |
| 2018 | $961.95 | $134.52 | 7.15x | $827.43 | $751.0K | 10.4K | 6.6K |
| 2019 | $865.78 | $126.78 | 6.83x | $739.00 | $782.6K | 11.2K | 6.7K |
| 2020 | $1.0K | $143.71 | 7.15x | $883.81 | $673.4K | 9.9K | 5.8K |
| 2021 | $1.0K | $142.81 | 7.06x | $866.09 | $823.6K | 11.3K | 6.8K |
| 2022 | $908.40 | $126.79 | 7.16x | $781.61 | $813.4K | 11.3K | 7.1K |
| 2023 | $965.83 | $130.61 | 7.39x | $835.22 | $760.2K | 11.5K | 7.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 20611 | Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance | 18.1K | $1.5M | $81.65 | 4.05x |
| 27447 | Repair of knee joint | 938 | $1.1M | $1.2K | 7.94x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 15.2K | $921.3K | $60.75 | 3.09x |
| 27130 | Replacement of thigh bone and hip joint prosthesis | 754 | $891.1K | $1.2K | 8.76x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.3K | $469.9K | $88.97 | 2.89x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.5K | $286.1K | $81.35 | 3.22x |
| 73564 | X-ray of knee, 4 or more views | 7.9K | $270.1K | $34.05 | 4.53x |
| J7321 | Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose | 3.0K | $196.1K | $66.23 | 13.29x |
| 73721 | MRI scan of leg joint | 1.0K | $181.1K | $173.79 | 7.15x |
| 73502 | X-ray of hip with pelvis, 2-3 views | 5.2K | $175.4K | $33.85 | 5.06x |
| 72148 | MRI scan of lower spinal canal | 1.0K | $164.2K | $163.87 | 8.06x |
| 73562 | X-ray of knee, 3 views | 4.0K | $120.2K | $29.79 | 4.64x |
| 20610 | Aspiration and/or injection of large joint or joint capsule | 2.1K | $104.4K | $50.71 | 4.42x |
| 27093 | Injection of dye for X-ray imaging of hip joint | 456 | $69.0K | $151.27 | 5.55x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 1.1K | $63.8K | $58.54 | 10.25x |
| 99204 | New patient outpatient visit, total time 45-59 minutes | 504 | $61.6K | $122.24 | 3.28x |
| 73221 | MRI scan of arm joint | 280 | $51.3K | $183.39 | 6.74x |
| 72170 | X-ray of pelvis, 1 or 2 views | 2.2K | $49.6K | $22.50 | 5.47x |
| J7320 | Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg | 3.2K | $41.8K | $13.10 | 2.67x |
| 73525 | Radiological supervision and interpretation X-ray of hip joint | 458 | $38.3K | $83.72 | 4.07x |
This provider submits charges 5.64 times higher than what Medicare actually pays.
A markup ratio of 5.64x means for every $100 Medicare pays, this provider initially charges $564. This is higher than the national average.
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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